This invention relates to tracheostomy tubes, and more particularly, to a tracheostomy tube having an adjustable neck plate.
Tracheostomy tubes are used to provide a means of airway management, for example, the bypass supply of oxygen or air to a patient when an obstruction occurs within the larynx or the pharynx area. Typically, the tracheostomy tube is inserted through an incision which is made in the patient's neck below the obstructed area. After the tube has been positioned in the trachea, the tube is held in place by a neck plate which includes slots for receiving a strap for tying the tube to the patient's neck. For existing adjustable tracheostomy tubes, once the tube has been fitted, the neck plate can adjust only for thickness of the neck of the patient. Fixed neck plate tracheal tubes cannot be adjusted. If a patient develops a tracheal malasia due to poor cuff maintenance or other complications, changing of the cuff site becomes critical. Under such circumstances, the care giver either must order a "custom" made product or attempt to alter the tube to meet the need, neither of which is a satisfactory solution from the patient discomfort standpoint.
Conventionally, the proximal end of the tracheostomy tube includes a connector for connection to a supply line which is connected to a ventilator or to a source of oxygen or air. It is important that the connector be allowed a degree of rotational freedom relative to the tube so that normal movement of the patient relative to the supply line is tolerated without exerting any torque forces on the tube. Accordingly, most tracheostomy tubes have swivel connectors fixedly connected thereto to facilitate connection to the supply line. Because the swivel connectors are fixedly mounted to the tube, they cannot be removed or replaced when the need arises.
Known tracheostomy tubes generally are made of a rigid material and are formed with a preset curvature, typically in the range of 70.degree. to 90.degree.. The curvature of the tube is somewhat difficult to alter because of the material of which the tube is made. In cases of abnormal tracheal anatomy, the shaft will kink or otherwise push on the tracheal wall, causing patient discomfort and in some cases damage or injury to the trachea. Indeed patient discomfort caused by prolonged cuff-tracheal pressure generally may result in patient injury. Moreover, the tubes may be made of a plastic material which is not radiopaque so that proper positioning of the tube can be determined only by external observation.
Some tracheostomy tubes that are currently available include mating inner and outer cannulas which are interconnected through the use of rigid flanges on a connector collar that is permanently formed on the outer tube or cannula. The inner cannula has associated therewith a connector collar having a knurled cap which is adapted to be tightened onto the connector collar on the outer cannula. Examples of such locking tracheal tubes are disclosed in U.S. Pat. No. 4,304,228, which was issued to William Depel, U.S. Pat. No. 4,009,720, which was issued to Norman C. Crandall and U.S. Pat. No. 3,659,612, which was issued to Donald P. Shiley. In these prior art tracheal tubes, the neck plates are integral with the connector collar and, as such, the neck plates are not adjustable axially of the tube.